Beyond the headache: Disparities in access to branded migraine therapies

A patient advocacy organization asked Symphony Health to investigate whether payer-imposed barriers (prior authorization, step therapy, outright rejection) to branded CGRP and other migraine therapies fall disproportionately on certain sociodemographic groups, and how that affects downstream ER visits and hospitalizations. Using a retrospective claims-based analysis via Symphony Health's Integrated Dataverse (IDV®), the study examined approval/rejection/reversal rates, ER/hospital admission rates, and patient abandonment (written but unfilled prescriptions) stratified by race, ethnicity, income, insurance type, and geography. It found some minority ethnic groups faced higher rejection rates than White/Caucasian patients, lower-income patients abandoned prescriptions more often, and patients facing utilization-management barriers like step therapy had higher ER and hospitalization rates for migraine-related complications.

The customer is anonymised in Symphony Health’s own case study — not withheld by us.

Symphony Health is a commercial claims and prescriber-data provider, recently divested from ICON plc to HealthVerity, supplying open/closed claims data for pharma commercial insight.

This sits in the Data Providers stage of the AI use-case lifecycle: Named examples from the real-world-data, claims and competitive-intelligence providers pharma AI systems are trained on, benchmarked against, or run inside of.